Hi! I believe I can be of help with this issue. First, let me say I can imagine how frightening this situation must be for you. On the one hand your daughter is clearly not functioning. But on the other hand judging from this combination of medications, she was most likely hospitalized at least once and was very unstable and/or suicidal at one point. And this is actually the key to my answer to you that you need to consider and think about. It is very difficult to determine which will be worse: the "overmedicated" state or the "undermedicated" state. Sometimes for a period of time, doctors find themselves caught in a no-win situation. They added more and more medications because the patient was not stabilizing with smaller medication regimes. They then find that in order to stabilize the patient, she is close to catatonic. The decision of which is worse is not easy to decide.
Therefore, I want to make sure that as you begin to work on this issue you recognize the overall attitude you have to assume in order to get the most of what you want: everyone to do their best for your daughter. Because I assume there is more than just one psychiatrist in private practice that has been involved with deciding on the meds. So, your attitude to every doctor and therapist and social worker that is or will be involved has to be one of gratitude, hope, and teamwork. Teamwork is the main thing. You need to commit before reading further that you will approach all these personnel as the team that is doing its best with each individual doing his/her best to help your daughter and to help you. If you approach them with this attitude, you will see they will go the extra mile for you whether you are rich or poor. So, this is priority one.
Next, you need to gather information: who is in charge of the team? Who's in charge of the big decisions? Who else is involved in her care? Are there therapists? Case workers?
I'm assuming here you have power of attorney over medical decisions for her. If not, you must have that to have any standing today. Assuming this, you need to ask if there can be a conference to discuss ongoing treatment for her in the future. You will want to bring up this issue of course. You will also want to bring up what are the possible outcomes that current treatment will have for the future. What are the types of treatments that might have the outcomes you are looking for? Are they practical?
Okay. All this assumes that you have a team set up. If there is now only one psychiatrist involved and nothing more, this is not enough. So discuss with him/her how you can get a psychologist involved for therapy and have that meeting with him/her I refer to above. He may not be confident to reduce meds with just himself on the scene occasionally when she is so heavily medicated. So, find out what he would need to feel comfortable beginning to streamline the meds and begin to focus more on therapy aimed at management of her condition. A psychologist? A clinic setting? A temporary residential setting?
Do you see how this works? It is not just a question of lowering numbers of meds and dosages. It is a matter of creating a strategy among the medical personnel for her treatment. That's your role, to drive the creation of a strategy and get them to help in actually make that strategy and begin to implement it.
I know this seems tough. But read over a few times what I've written you and you'll see that it is all about getting people to feel you trust them and be willing to then help you in ways you can understand.
I wish you and your daughter the very best!
Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX